Community-acquired respiratory virus infections in lung transplantation:assessment of impact and treatment strategies

The effect of respiratory viruses in lung transplant recipientsRespiratory viruses are very common. The most well-known is currently the SARS-CoV-2 virus (causing COVID-19), however other -lesser known- respiratory viruses infect millions of people every year. In healthy persons these infections are usually mild, but in more vulnerable people such as the elderly, young children or organ transplant recipients they may manifest more severely.In this thesis De Zwart studied the effects of different respiratory viruses on the pulmonary function of lung transplant recipients, with an emphasis on respiratory viruses other than SARS-CoV-2.The research underlines that the effects of these respiratory viruses in lung transplant recipients can be large. The probability of developing chronic damage of the transplanted lungs seems to be significantly higher after infection with a respiratory virus. This is of great importance since this chronic damage greatly limits survival after transplantation. Respiratory viruses that are very common, but have traditionally garnered less attention (such as parainfluenza virus) seem to cause similar damage as influenza virus. Unfortunately there is also only limited evidence available for the effectiveness of treatment of respiratory virus infections with antiviral medication. De Zwart also shows a striking side-effect of the lockdown measures taken in the Netherlands. Despite the abundance of SARS-CoV-2 during the period with social-distancing measures, there was a sharp decrease in circulation of other respiratory viruses during this period (often >80%). This has possibly had a surprisingly positive effect on the lung function of lung transplant recipients: usually the lung function decreases a little bit every year, but during the social-distancing period it stabilized.This thesis therefore emphasizes the thought that several respiratory viruses (so also different ones than SARS-CoV-2) should not be underestimated and may have a greater effect on pulmonary function than previously thought